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November 4, 2024
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Predicting high risk of exacerbations in bronchiectasis: The E-FACED score

Publicated to: International Journal of Chronic Obstructive Pulmonary Disease. 12 275-284 - 2017-01-18 12(), DOI: 10.2147/COPD.S121943

Authors:

Martinez-Garcia MA; Athanazio RA; Girón R; Máiz-Carro L; de la Rosa D; Olveira C; de Gracia J; Vendrell M; Prados-Sánchez C; Gramblicka G; Corso Pereira M; Lundgren FL; Fernandes De Figueiredo M; Arancibia F; Rached SZ
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Affiliations

Centro de Investigación Biomédica en Red de Enfermedades Raras; Hospital Universitari Vall d'Hebron - Author
Hospital de Messejana - Author
Hospital Octávio de Freitas - Author
Hospital Plató - Author
Hospital Regional Universitario Carlos Haya - Author
Hospital Universitari de Girona Dr. Josep Trueta - Author
Hospital Universitari i Politècnic La Fe; Centro de Investigación Biomédica en Red de Enfermedades Raras - Author
Hospital Universitario de la Princesa - Author
Hospital Universitario La Paz - Author
Hospital Universitario Ramón y Cajal - Author
Hospital Zonal de Agudos y Cronicos Dr. Antonio A. Cetrangolo - Author
Instituto Nacional del Torax - Author
Universidade de Sao Paulo - Author
Universidade Estadual de Campinas - Author
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Abstract

Background: Although the FACED score has demonstrated a great prognostic capacity in bronchiectasis, it does not include the number or severity of exacerbations as a separate variable, which is important in the natural history of these patients. Objective: Construction and external validation of a new index, the E-FACED, to evaluate the predictive capacity of exacerbations and mortality. Methods: The new score was constructed on the basis of the complete cohort for the construction of the original FACED score, while the external validation was undertaken with six cohorts from three countries (Brazil, Argentina, and Chile). The main outcome was the number of annual exacerbations/hospitalizations, with all-cause and respiratory-related deaths as the secondary outcomes. A statistical evaluation comprised the relative weight and ideal cut-off point for the number or severity of the exacerbations and was incorporated into the FACED score (E-FACED). The results obtained after the application of FACED and E-FACED were compared in both the cohorts. Results: A total of 1,470 patients with bronchiectasis (819 from the construction cohorts and 651 from the external validation cohorts) were followed up for 5 years after diagnosis. The best cut-off point was at least two exacerbations in the previous year (two additional points), meaning that the E-FACED has nine points of growing severity. E-FACED presented an excellent prognostic capacity for exacerbations (areas under the receiver operating characteristic curve: 0.82 for at least two exacerbations in 1 year and 0.87 for at least one hospitalization in 1 year) that was statistically better than that of the FACED score (0.72 and 0.78, P,0.05, respectively). The predictive capacities for all-cause and respiratory mortality were 0.87 and 0.86, respectively, with both being similar to those of the FACED. Conclusion: E-FACED score significantly increases the FACED capacity to predict future yearly exacerbations while maintaining the score’s simplicity and prognostic capacity for death.
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Keywords

BronchiectasisE-faced scoreExacerbationsFaced scoreMortality

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal International Journal of Chronic Obstructive Pulmonary Disease due to its progression and the good impact it has achieved in recent years, according to the agency Scopus (SJR), it has become a reference in its field. In the year of publication of the work, 2017, it was in position , thus managing to position itself as a Q1 (Primer Cuartil), in the category Health Policy. Notably, the journal is positioned above the 90th percentile.

From a relative perspective, and based on the normalized impact indicator calculated from World Citations from Scopus Elsevier, it yields a value for the Field-Weighted Citation Impact from the Scopus agency: 7.21, which indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: ESI Nov 13, 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2026-04-05, the following number of citations:

  • Scopus: 150
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Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2026-04-05:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 127.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 127 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 13.
  • The number of mentions on the social network Facebook: 1 (Altmetric).
  • The number of mentions on the social network X (formerly Twitter): 1 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.
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